Comparison results of the population's COVID-19 preventive behaviours / Монголын Анагаах Ухаан

Background@#As of September 21, 2021, 65.3 percent of Mongolia's population was vaccinated at full dose. However, as of COVID-19 confirmed cases, Mongolia is in the top five countries in the West Pacific. This indicates that there is a lack of practice to prevention from coronavirus infection in the population.@*Goal @#This survey aims to compare the level of knowledge, attitudes, and practices of the population towards coronavirus infection with the results of the baseline survey results @*Material and Methods@#This is a cross-sectional study. A total of 1896 people aged 15-60 years old participated in the study. The survey data were collected using quantitative (questionnaire) and qualitative (observation) methods. The research methodology was approved at the Scientific Committee of the National Center for Public Health on November 9, 2021 (Protocol № 5) and the Medical Ethics Review Committee of the Ministry of Health on January 20, 2022 (Resolution №261) was issued the Ethical permission of the survey. @*Results@#Out of 14 knowledge questions that should be known about coronavirus infection, survey participants had known in an average of 8.27 ± 3.73 (95%CI: 8.12-8.43) correct answers, which was lower than the results of the baseline study. The average knowledge score of the surveyed participants of the follow-up survey (9.23±3.2, 95%CI: 9.09-9.38) was smaller than the baseline survey by 0.96 percent. 54.5 percent of surveyed participants believed that the pandemic is “very dangerous”. However, it has decreased by 25.6 percent compared to the baseline survey. Positive attitudes toward the right place at the onset of symptoms of COVID-19 and non-discrimination against infected people are more prevalent in a population with a high average knowledge score. In the baseline study, the average duration to wear a mask was 29 hours, while in the follow-up survey, it was 4.2 hours, which shows improvement in the correct behavior. @*Conclusions@#As the population’s level of education increased, the average knowledge score on the coronavirus infection has increased, and the statistically significant high of the participant with higher education levels was 8.81±3.53 (p=0.0001). In the baseline survey, 64.9 percent of the participants had an attitude toward a discriminant person infected with COVID-19, whereas it was declined by 41.9 percent in the follow-up survey. The practice of wearing masks in crowded places and outdoors were increased by 6.8 percent from the baseline survey. Compared to the baseline survey results, in the follow-up survey, practices of wearing masks in the workplace or indoor environment (73.0%) had increased.

Assessment of secondary school indoor air quality / Монголын Анагаах Ухаан

Introduction@#During this pandemic, overcrowding in classroom caused by a lack of educational facilities and poor indoor air quality are the main causes of respiratory diseases among children and adolescents. Therefore, it is essential to measure and assess the indoor air quality where children spend extended periods of time such as school. @*Materials and methods@#This study covered four schools with old buildings and four schools with new buildings in Bayanzurkh, Sukhbaatar, Khan-Uul, Chingeltei district of Ulaanbaatar. We collected PM10 and PM2.5, carbon dioxide, air temperature, humidity, and microbiological count from chosen classrooms and compared to the MNS4585:2016 standard. SPSS-24 was used to do statistical analysis on the information gathered during the evaluation.@*Results and Discussion@#The 24-hour average PM2.5 concentration was 64.3 (95% CI: 64.1-64.5) mcg/m3, which was 4.3 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016 standard. The 24-hour average PM10 concentration was 85.3 (95 % CI: 85.1-85.6) mcg/m3, which is 1.9 times higher than WHO guideline value. In older school buildings, the 24-hour average PM2.5 concentration was 5.6 times higher than the WHO guideline value and 1.7 times higher than the MNS4585:2016; the average PM10 concentration was 2.8 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016. The air temperature and carbon dioxide concentration in classroom was met the MNS4585: 2016. The average relative humidity of all schools is 24.2±6.5%, which is 14-16% lower than the MNS4585: 2016. @*Conclusion@#The indoor air quality of the school in new and old buildings was similar poor, therefore a variety of steps are needed to improve it.

Evaluation of air pollution prevention consultation, Ulaanbaatar / Монголын Анагаах Ухаан

Introduction@#Mongolia’s capital hosts about half the country’s total population, and its air pollution ranks among the highest in the world during winter. Air pollution is linked to reduced fetal growth, preterm birth, low birth weight, impaired cognitive intra-uterine development, impaired cognitive development, and even spontaneous abortion. Antenatal care includes fetal development monitoring, prevention of anemia, immunization against infectious diseases, prevention of sexually transmitted diseases, and any health risk factors such as environmental pollution. </br>Health care measures for pregnant women and children under one year of age have the potential to be highly effective because they are directly aimed at reducing pneumonia in children. As such, we need to conduct this survey to determine whether pregnant women were satisfied with the information and advice on air pollution prevention provided by health facilities and to take evidence-based measures.@*Materials and Methods @#The survey data were collected using quantitative and qualitative research methods. In this study, a total of 958 pregnant women participated from Songinokhairkhan district, Bayanzurkh district, and Bayankhongor province center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation, and environment of the Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. The research methodology was discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2).@*Results @#The survey covered 958 pregnant women aged 16-45 in Bayanzurkh district Songinokhairkhan district, and Bayankhongor province. During antenatal care visits, the majority of pregnant women (BZD- 56.9%, SKHD- 68.3%, BKH province - 86.7%) were advised by their health specialists to go outside for fresh air, while women in Ulaanbaatar (BZD- 18.9%, SKHD- 24.7%) received the information and advice at the lowest percentage. Pregnant women in Ulaanbaatar were less involved in air pollution training than in Bayankhongor. Participants in the air pollution prevention training rated it as “satisfied” regardless of location. 37.2% of pregnant women obtained information on protecting their health from air pollution from the board of Family Health Center and 34% from their district health centers. 86.1% of the participants were able to obtain information on air pollution on their own, while 86% of them got information from their family and friends. @*Conclusion @#The percentage of pregnant women getting medical advice, training, and information on air pollution prevention from hospitals during their antenatal care visits was the highest in rural areas. Moreover, their level of satisfaction with counseling had been rated as “satisfied”. Pregnant women often seek information on air pollution prevention from non-professional sources, such as their family and friends.

Determination of concentrations of indoor air pollutants emitted from briquette combustion / Монголын Анагаах Ухаан

Introduction@#This field assessment was performed to ensure the effective implementation of Order No. A/142 of the Deputy Prime Minister of Mongolia dated 30^th December 2021 and Order No. A/01 of the Head of the National Committee for Reducing Environmental Pollution dated 3^rd January 2022 and to monitor the level of indoor air pollutants emitted from traditional stoves and standard stoves. @*Purpose@#To determine the level of indoor air pollutants emitted from briquette combustion and to develop recommendations by comparing various types of stoves and dwellings. @*Materials and Methods@#Through analytical cross-sectional designs, three households from Songinokhairkhan district and one household from Chingeltei district were selected to participate in this assessment as they use briquettes for heating, vary in their dwelling types (ger (traditional Mongolian tent), house) and their stove types (traditional, standard), stay home during the day and chose to participate in the assessment. 24-hour continuous measurements were conducted for each dwelling and before taking measurements, we calibrated and adjusted the air suction velocity of the measuring instrument at the Central Metrology Laboratory. The monitor was placed at a distance of 0.5m from the stove and a height of 0.5-1.0m from the floor. The results were then compared with the Mongolian National Standard “General air quality and technical requirements MNS4585:2016” and WHO Guidelines for Indoor Air Quality 2021. Statistical analysis was performed using SPSS 24.0 software, mean, ANOVA test, and if the p-value is less than 0.05, our results are statistically significant.@*Results@#The concentration level of SO₂ in houses with “Dul” stoves was within the level specified in the Mongolian standard MNS4585: 2016 and WHO Guidelines for Indoor Air Quality 2021, while 24-hour SO₂ concentration in gers and houses with traditional stoves was 1.3-2.92 times higher than the standards. The 24-hour average concentration of nitrogen dioxide in houses with traditional stoves was 1.73 times higher than the Mongolian air quality standard MNS4585: 2016. There were statistically significant differences in the emission levels of SO₂ and NO₂ depending on dwelling and stove types (df=4, f=4.04, p=0.008 and df=4, f=17.17, p=0.001, respectively.). The 8-hour average (10,000 μg/m3) CO concentration was statistically significant for various types of dwellings and stoves (df=4, f=45.17, p=0.001), whereas there was a statistically significant difference in CO concentrations in gers with traditional stoves and gers with standard stoves in terms of morning, afternoon, and evening hours (df=3, f=33.17, p=0.001). @*Conclusion@#Indoor air pollutants in the households except for houses with “Dul” stoves have been determined to exceed the air quality standards set by the Mongolian air quality standards and WHO Guidelines for Indoor Air Quality 2021.

The result of disinfection of pit latrine with “Gipon” ionized disinfectant solution / Монголын Анагаах Ухаан

Introduction@#Sanitation facility supply and service availability of Mongolia is essential due to the slow process of bacterial decomposition which is getting significant difficulties because of the cold and arid climate. Only 37 percent of Ulaanbaatar’s population is connected to the central sewerage system, and the majority of ger area residents, or 95 percent, use pit latrines in demand of sanitation facility. Numerous studies have shown that the main contaminant of the soil in ger area were pit latrines. It not only pollutes the environment but also affects human health. There is a lack of awareness about the transmission of infectious diseases and options of new sanitation facilities and poor knowledge and bad conditions to introduce new drainage systems. Most pit latrines in ger areas are of poor quality and do not meet relevant standards.@*Goal@#To determine the effect of ”Gipon” ionized disinfectant solution produced by Japanese technology for disinfecting pit latrines@*@#@*Material and Methods@#This study was conducted in December 2019 using a random sampling method. Five households in ger areas were selected and pit latrines were disinfected by ”Gipon” ionized disinfectant solution.@*Results@#The survey covered pit latrines of 5 households in the 21st khoroo of Bayanzurkh district. All owners allowed to participate in the survey. The pit latrines are located approximately 9.8 meters away from the households participated in survey. They have been utilized it for 7.6 years and used by an average of 6 people per day. For inner cover, 60.0 percent are lined with wood, and 40.0 percent are cleaned once a month. Before the use of the disinfectant solution, having taken the swab from door handles, floors and walls of the toilet and were detected Enterobacter spp, E.Coli, and Pseudomonas spp in all samples. </br> However, after one and 24 hours of spreading of the disinfectant solution, the amount of intestinal coliform bacteria and E. coli was reduced dramatically and in some places no bacterial were detected. 72% of the soil near the latrines in the study covered ger areas was contaminated with bacteria. In terms of E.Coli contamination in soil, 60% of them were contaminated in low degree and 32% were medium and 8% were high degree. Anaerobic microorganisms such as Cl.prefrings were accounted for 82% of the total sample, 19% moderate and 81% low contamination.@*Conclusion@#Intestinal coliform bacteria (Enterobacter spp, E.Coli, Pseudomonas spp) and pathogenic bacteria (Serratia spp, Staphylacoccus spp) were not detected and the number of fungi was sharply reduced after 1 and 24 hours using Hypon disinfectant. No intestinal pathogens (Salmonella spp, Citrobacter freundii) were found in the soil near the latrine. The amount of coli titers was reached to the acceptable limits. According to this study, the disinfection activity of “Gipon” solution was ranging from 105 to 104.

Satisfaction of health care and services for parents and guardians with 0–5 years-old children / Монголын Анагаах Ухаан

Introduction@#Within the framework of health sector reform, the development of the organization, the responsibility of doctors and medical professionals, and the improvement of ethics, quality and safety of care and services are top priorities. Customer satisfaction is important for the implementation of this operation based on results and quality. The WHO Recommendation states that health professionals have a key role to play in providing information and advice to citizens and their families on how to prevent, mitigate and address air pollution, and how to inform the general public and decision-makers. ADB, the Ministry of Health, and UNICEF report that information and promotional materials on air pollution prevention are scarce and do not provide advice to clients. Therefore, it is the reason for conducting a survey to determine the level of satisfaction of clients receiving child health care.@*Materials and methods@#The survey data were collected using quantitative and qualitative research methods. In this study, totally 1160 guardians of children aged 0-5 participated from Songinokhairkhan and Bayanzurkh district and Bayankhongor aimag center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation and environment of Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. Research methodology discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2).@*Results@#84.7 percent of the respondents were parents of children aged 0-5 years. Their average age is 34, most of them have higher education, and 43.0 percent of them have a household income of 500,000-1 million MNT. Guardians of children aged 0-5 years in Bayanzurkh District were “dissatisfied” with the Family Health Center’s dressing room, wardrobe, toilet and parking lot. Guardians of children aged 0-5 years in Songinokhairkhan district were “dissatisfied” in the parking lot and toilet of the health organization. Guardians of children aged 0-5 years in Bayankhongor aimag were satisfied with the services, operation and environment of the health organization. Studies have shown that 76.5 percent of the guardians did not receive air pollution risk training. As for difficulties in preventing air pollution, 31.4 percent of the surveyed population answered that they cannot change their living and working environment to prevent air pollution.@*Conclusion@#It shows the health care organizations need to improve the hospital environment as well as to provide training how to protect children from air pollution risk for guardians.

Health professional’s knowledge, attitude and practice (KAP) on air pollution / Монголын Анагаах Ухаан

Introduction@#Soum and family health care centers (primary health care centers) provide public health services to reduce the negative effects of air pollution on health. In order to decrease the risk factors due to air pollution, it is crucial for health professionals, who are providing health care services to the public, to have the knowledge, attitude and practice to give an advice for residents on how to protect their health from air pollution. The “Air pollution and child health” report from WHO recommended that responsibility of health professionals must include knowing the latest information on air pollution, doing a research, spreading the knowledge, educating families and community and learning from them as well, proposing solutions, and finding a solution for policy developers and decision makers in other sectors. Therefore, we conducted this survey with purpose to determine the long-term effects of air pollution on population psychology and lifestyle and to evaluate the level of knowledge, attitude, and practice of health professionals on how to protect a health from air pollution.@*Goal@#Evaluate the level of knowledge, attitude, and practice of health professionals on air pollution.@*Material and Methods@#In 2019, this study conducted a cross-sectional design and collected quantitative and qualitative data. 88.4% of (n=532) health professionals from 48 secondary health care centers (SHCC) and 64 family health care centers (FHCC), which are agents that implement UNICEF project, in Bayanzurkh, Songinokhairkhan districts and Bayankhongor aimag were participated in the survey.@*Results@#97.4% of the participants agreed that air pollution has negative effects on human health. 99.5% of participants did not know the Mongolian standard for the acceptable level of air pollutant particulate matter (PM) and 73.1% of all participants did not receive information about air quality index. 82.1% of participants regularly give prevention advice with the purpose of protecting maternal and child health from air. The participants who worked for more than 21 years and who are older than 51 years old were more likely to give advice (p<0.05). As for the reasons for not giving advice about air pollution for protecting the maternal and child health, 29.2% of participants answered the service time is not enough, and 22.9% mentioned the lack of knowledge and information. 30.5% (162) of participants were not satisfied with their skill to give an advice on how to protect maternal and child health from air pollution. 86.8% of participants indicated that they did not receive proper training on air pollution and prevention from air pollution.@*Conclusion@#There is a need to provide training and information on how to protect maternal and child health from air pollution for health professionals.